The Trouble With Teeth

How to handle chips, knockouts and other dental drama

Keeping a child’s smile healthy takes brushing twice daily, avoiding sweets and visiting the dentist regularly. In the case of a dental emergency, it also takes quick thinking and swift action. In addition to the normal loss of baby teeth and a cavity or two, many children experience some type of tooth-related trauma like a chipped tooth or one that suddenly turns grey. While childhood dental dramas are common, experts warn against ignoring issues simply because they involve baby teeth. Problems with baby teeth can affect developing permanent teeth. Read on for help with dental problems, from minor mishaps to true emergencies.

Early Years: Shades of Grey

Many parents are dismayed when one of a toddler’s pearly whites isn’t white at all, but instead a shade of grey or light brown. Don’t panic! Baby teeth have shallower roots than permanent teeth. With even a slight bump, a tooth can “die” and lose its white luster. Dentists generally advise a wait-and-see approach to a greying baby tooth, because it usually is an aesthetic issue.

In some cases, however, a dead or dying tooth becomes infected, forming an abscess, says pediatric dentist Dr. Cami Miskovic of Charlotte Pediatric Dentistry. In these cases, a dentist can extract the tooth and treat the underlying infection. If the tooth has to go, take heart — it won’t affect spacing of the permanent teeth, and your little one may get to be the first of his or her pals to get a visit from the Tooth Fairy.

Elementary Years: Knockout

During the early school years, children lose most of their baby teeth and learn to care for their new adult choppers. Because children are so active during this stage, it’s not uncommon to knock out a tooth. A knocked-out tooth is a dental emergency that warrants an immediate call to your dentist. Southpoint Pediatric Dentistry in Durham advises carefully handling the tooth by the crown, not the root, and holding it in its socket with a finger if possible. If it’s not possible to handle the tooth by its crown, store the tooth in a glass of milk. If the tooth is a permanent one, your dentist may be able to restore it in its original position.

Another common dental dilemma is permanent teeth coming in before baby teeth fall out that can result in multiple rows of teeth. This can look odd, but the tongue pushes permanent teeth into alignment once the baby teeth fall out, says pediatric dentist Dr. Sabrina Magid Katz of Advanced Dentistry in Westchester, New York. Encourage your child to keep wiggling the baby teeth. If one is particularly stubborn, your dentist can help coax it out.

Teen Years: Chip Off the Old Block

Chomping ice, using teeth to open a bottle or playing sports can lead to something most teens don’t want in their yearbook photo: a chipped tooth. While minor chips are mostly an aesthetic issue, a larger chip can expose nerve endings that make a tooth extremely temperature-sensitive and very painful. If your child chips a tooth, dentists at Southpoint Pediatric Dentistry advise trying to locate the missing piece, putting it in water and calling your dentist right away.

A severe break may qualify as an emergency, while more minor chips can probably wait until the next business day. If the broken piece can’t be found, a dentist can create a composite filling to restore the tooth. Composites look natural and can last for years, though your child may need to replace the composite at some point in his or her lifetime. To avoid chips, have your teen wear a mouthguard for sports, advise him or her to never use teeth as “tools.”

Malia Jacobson is a nationally published health journalist and mom.